If a Mount Rushmore of Epidemiology were to exist, Joseph F. Fraumeni Jr. would be etched into the face of the mountain, former NCI Director Ned Sharpless once told Stephen J. Chanock.

Of the hundreds of scientists Fraumeni mentored, perhaps one of the closest was Stephen J. Chanock, his successor as director of the NCI Division of Cancer Epidemiology and Genetics, who worked with Fraumeni for 25 years.

Fraumeni died on June 22. He was 93.

Otis Brawley, co-editor of the Cancer History Project and the Bloomberg Distinguished Professor of Oncology and Epidemiology at Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, interviewed Chanock on the most recent episode of the Cancer History Project podcast.

Brawley and Chanock looked back on Fraumeni’s 50-year long career. His contributions to science included co-discovering the Li-Fraumeni syndrome and developing cancer maps, which visualize cancer rate data from every county in the U.S. His work served as a backbone for other major discoveries, such as the two-hit hypothesis by Alfred Knudson and BRCA genes.

Fraumeni developed theories around how cancer works and tested them.

“The mission statement of DCEG has been to understand the etiology of cancer through epidemiology and genetics as a means to prevention or early intervention,” Chanock said. “That's really the wisdom of Joe Fraumeni who lived that, and really developed the tools, the capabilities, and the workforce to pursue that.”

As a result, Fraumeni established a vision of cancer's genetic susceptibility. His observations about diethylstilbestrol raised “a very revolutionary idea” that early exposures could result in precancerous conditions and develop into cancers decades later. The cancer maps added a new attention to cancer caused by environmental exposures.

“These patterns were very important, which led to understandings about what was going on post-World War II and [how] certain occupations are associated with select cancers,” Chanock said. “This led to the birth of a whole set of cohorts and case control studies to look at asbestos, smelters, occupational hazards and smokeless tobacco use in the South.”

The goal was always to help patients, many of whom had no options at the start of Fraumeni’s career.

“What Joe was envisioning was the more we understand, the more we can be honest and explain to our patients who develop cancer or may develop cancer, what we could be done to prevent or decrease that risk,” Chanock said.

The Cancer History Project Podcast is sponsored by City of Hope, the American Society of Clinical Oncology, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and the University of Texas MD Anderson Cancer Center.

A transcript of this conversation, along with an archive of related content, is available on the Cancer History Project: https://cancerhistoryproject.com/article/joseph-f-fraumeni-jr/